Insurance automated claims processing solution

Large insurance carrier providing comprehensive financial planning services and a wide spectrum of insurance products

Duration
24 months
Team
8 persons
Platforms
Web
Type
Insurance Company
Industry
Insurance Technology

Target audience

Individuals, families, and business owners who seek fast and reliable insurance solutions.

Project idea

Build an end-to-end claim processing software solution to improve cycle time through minimized manual procedures, facilitate data collection, and cut operational costs for claims processing by introducing an insurance rating engine, business rules, and workflow capabilities. Reduce the risk associated with obsolete technologies, ensure scalability and compliance when making business process changes.

Project challenges

Develop an automated claims management system to enable faster & simpler claims processing.
Build workflow and task management functionality to optimize and enhance the existing business processes.
Integrate with customer service and back-office applications to allow managing the processes from within a single interface.
⁠Implement a robust backup mechanism to secure the data from any loss or damage.
Create advanced form builders to offer convenient, personalized self-service

Solution

We delivered an advanced solution that reduces the administrative burden of the claims team, reduces paperwork and service time, and delivers simpler and faster claims servicing to claimants. With a strong focus on reducing turnaround time per claim and improving regulatory compliance, ApexTech designed and implemented an automated claims processing system that enabled effective case management, intelligent task creation, and distribution. Visual workflow tools facilitated the formation of custom processes for claims and underwriting teams. ApexTech helped the client achieve faster time to market, streamline processes, and reach greater productivity.

Business benefits

01
Productivity
TIncreased capacity and improved business process efficiency.
02
Performance
Shortened turnaround time for claims processing & policy generation.
03
Enhanced customer experience
Simplified procedure of claims submission via self-service, providing a higher level of customer service.
04
Automation
Most of the previously manual tasks were automated.
05
Increased ROI
Reduced cost of delivery for underwriting products.

What we did

Phase 1

We conducted a discovery process to ensure that automated processes accurately reflect the work methodology and policies of the organization. The insurance solution is a PHP-based application with a MySQL database at the back-end. We built a centralized data repository with access control defined around user roles and highly customized workflows. Our team built business logic and user interface with a state-of-the-art design for insurance automated claims processing platform. The front-end part was developed using CSS, HTML, and JavaScript, as well as the Bootstrap UI library, which allowed us to deliver an intuitive and interactive, yet simple UI.

Phase 2

Claim processing platform developed by our software engineers automatically performs the steps included in claim decision-making and provides a configurable rules engine that streamlines general operations. Claims are assigned to the staff members according to the user roles, responsibilities, and departments. The platform comes with tools for business-led configuration and technical customization. An advanced web-based dashboard enables system admins to manage users and their roles, set up e-mail notifications, specify and alter claims categories.

Phase 3

We implemented a form builder tool to provide flexibility in creating data forms, enabling each customer to build and customize forms according to specific requirements and needs. ApexTech team also added a PDF document generation tool. With its in-built web-based visual template editor, the service allows automating insurance quote generation, customizing invoices, reports, and other types of templates, and later on, converting them into PDF files.

Phase 4

We integrated claims processing software with the third-party service customer and back-office systems to provide seamless business process flow. Our specialists also developed a mechanism for searching and importing the information connected with claims from third-party applications and smooth data sharing between the diverse departments. With the help of the ElasticSearch tool, we created the search feature that provides rapid auto-complete functionality for finding claims along with a robust search by multiple criteria.

Phase 5

We designed and delivered a reliable and efficient solution for backing up databases and file services. ApexTech specialists implemented a complex data backup mechanism, whereby the data was replicated on the server at first, and only then the backup process started, ensuring the system’s reliability.